Not everyone in Cuba receives substandard healthcare. Senior Cuban Communist Party officials and those who can pay in hard currency have access to first-rate medical services.

This situation exists because the Cuban Government has chosen to develop a two-tiered medical system--the deliberate establishment of a kind of "medical apartheid"--that funnels money into services for a privileged few, while depriving the healthcare system used by the vast majority of Cubans of adequate funding.

Following the loss of Soviet subsidies, Cuba developed special hospitals and set aside floors in others for exclusive use by foreigners who pay in hard currency. These facilities are well-equipped to provide their patients with quality modern care. Press reports indicate that during 1996 more than 7,000 "health tourists" paid Cuba $25 million for medical services.

Cuba's "Medical Technology Fair" held April 21-25, 1997 presented a graphic display of this two-tier medical system. The fair displayed an array of both foreign and Cuban-manufactured medicines and high-tech medical equipment and services items not available to most Cubans. The fair showcased Cuban elite hospitals promoted by "health tourism" enterprises such as SERVIMED and MEDICUBA.

Members of the Cuban Communist Party elite and the military high-command are allowed to use these hospitals free of charge. Certain diplomatic missions in Havana have been informed that their local employees can be granted access privileges to these elite medical facilities--if they pay in dollars.

The founder of Havana's International Center for Neurological Restoration, Dr. Hilda Molina, quit her position in 1994, after refusing to increase the number of neural transplant operations without the required testing and follow-up. She expressed outrage that only foreigners are treated. Dr. Molina resigned from her seat in the national legislature and returned the medals Fidel Castro had bestowed on her.

In 1994, Cuba exported $110 million worth of medical supplies. In 1995, this figure rose to $125 million. These earnings have not been used to support the healthcare system for the Cuban public. In fact, tens of millions of dollars have been diverted to support and subsidize Cuba's biomedical research programs--money that could have been used for primary care facilities.

Another means of earning foreign exchange at the expense of providing healthcare to ordinary Cubans is the government's policy of exporting its doctors to other countries. Three hundred Cuban doctors are in South Africa alone. In the early 1990's, Cuba reportedly planned to have 10,000 physicians abroad by the turn of the century.

A group of Cuban doctors who recently arrived in the United States said they were "mystified" by claims in a recent report of the American Association for World Health (AAWH) that the United States embargo is to be blamed for the public health situation in the country.

According to these doctors, "we...can categorically and authoritatively state that our people's poor health care situation results from a dysfunctional and inhumane economic and political system, exacerbated by the regime to divert scarce resources to meet the needs of the regime's elite and foreign patients who bring hard currency."

Referring to the growing disparity between healthcare provided to ordinary Cubans and that offered to tourists and high ranking Communist party members, the Cuban doctors noted that they "wish that any one of us could provide tours to foreign visitors of the hospitals Cira Garcia, Frank Pais, CIMEQ, and Hermanos Ameijeiras, in order to point out the medicines and equipment, even the bedsheets and blankets, reserved for regime elites or dollar-bearing foreigners, to the detriment of our people, who must bring their own bedsheets, to say nothing of the availability of medicines."

This statement is supported by the latest available trade figures for Cuba (1995). Cuba's imports totaled $2.8 billion, yet only $46 million--only 1.5% of overall foreign purchases--was spent on medical imports for its 11 million people. In comparison, the Dominican Republic, Cuba's neighbor, spent $208 million on medical imports for its 7.5 million citizens in 1995.